title: Toward a phenomenology of boundaries in medicine: chronic illness experience in the case of stroke.
abstract: In this article I explore the ambiguous nature of the boundaries of authority and responsibility in medicine by discussing two dimensions of patients' response to long-term ramifications of stroke. A phenomenological examination of the chronic illness experience is employed to identify how and the extent to which medicine's power both responds to and affects the individual sufferer. Rather than interpret the illness process as a dichotomy between medical control and patient autonomy, this article presents some assumptions about the boundaries of medical authority that are held by patients and practitioners alike. I suggest that dilemmas that patients face following a stroke are responses to medicine's limits and scope as well as reflections of medicine's goals and values. I argue that phenomenological studies of existential responses to illness are necessary in order to understand cultural sources of unmet expectations resulting from chronic conditions.
authors.affiliation: Institute for Health and Aging, University of California, San Francisco, CA 94143, USA.
authors.forename: Sharon R
authors.initials: SR
authors.lastname: Kaufman
mesh_terms: D000368:Aged; D002908:Chronic Disease; D003243:Consciousness; D006801:Humans; D008297:Male; D026684:Personal Autonomy; D010686:Philosophy, Medical; D010817:Physician-Patient Relations; D020521:Stroke / Q000503:physiopathology / Q000523:psychology; D000071939:Stroke Rehabilitation